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Health Care Law Heads To The High Court

SUSAN STAMBERG, BYLINE: This is WEEKEND EDITION from NPR News. I'm Susan Stamberg. Rachel Martin is on assignment.

In Washington, D.C. this time of year, we are used to seeing lines of people strolling under our famous cherry blossom trees. But this morning, there is also a line outside the Supreme Court, people hoping to get a glimpse of arguments in one of the biggest cases in decades. The justices have set aside six hours to debate whether the Obama administration's Affordable Care Act is constitutional. The health care law is the single biggest accomplishment of the Obama presidency.

And NPR's Ari Shapiro joins us to talk about what's going to happen over the next few days. Good day to you, Ari.


Hi, Susan.

STAMBERG: Break down these six hours, incredible, of debate for us. How come so much time on a single case?

SHAPIRO: It's almost easier, Susan, if you think of it not as one case but as four. There are four distinct legal questions that the court wants lawyers to argue in this case. And they set aside blocks of time for each of those questions. So, for example, the very first question up tomorrow morning is whether the penalty that you pay if you don't have health insurance in 2015 is actually a tax.

STAMBERG: Yeah, but why does that matter whether the penalty is or is not a tax?

SHAPIRO: Well, if it is a tax, then the court has no right to hear this case. The law says you can only challenge a tax once you have already paid it, and that penalty doesn't set in until 2015. So this could be a way for the court to avoid dealing with the harder questions and just kind of punt on the decision, on the substance of the law for a few years.

Most court watchers don't think that's going to happen. They think the justices will actually take on the meatier issues. But interestingly, this tax question is not something the two sides in the case disagree on. They both want the court to rule on the substance. The court just asked for arguments on this tax question, and even appointed someone to make the devil's advocate argument that it is a tax.

STAMBERG: And after the tax issue is a question about the law's individual mandate. Would you please remind us what that means, individual mandate?

SHAPIRO: Right, so this is the centerpiece of the law. The Obama White House says it is what makes the system work. The law's opponents say it's what makes the law unconstitutional. The individual mandate says everyone has to have health coverage whether you buy it on your own or you get through your employer. And that requirement allows the system to cover everyone regardless of pre-existing conditions they might have.

The way it works is if you have a guarantee that everyone will get coverage, but you don't have a requirement that everyone must have coverage their whole life, then people just buy them when they get sick. And the system kind of collapses under the weight of the sick people. So opponents of the individual mandate say the U.S. has never before required everyone to buy a product, and that this encroaches on individual freedom.

The law's supporters say health care something everyone is going to need one day, so you're not really making people buy something that they would otherwise not buy.

STAMBERG: I see. OK, so that brings us to Wednesday. And that's the only day with morning and afternoon arguments, as I understand it. What will those be about?

SHAPIRO: Well, two completely separate legal questions from the morning to the afternoon. The morning question is another one that the court asked for briefing on. It asks whether striking down the individual mandate means the whole law must fall. The question is whether the mandate is severable, whether you could uphold the rest of the law, get rid of the mandate.

And then in the afternoon comes the last big substantive disagreement about this law, which has to do with the expansion of Medicaid. The law expands Medicaid coverage and says the states have to go along or they lose federal Medicaid money. Again the question is whether the federal government overreached.

STAMBERG: NPR White House correspondent Ari Shapiro, thank you.

SHAPIRO: Good to talk to you, Susan. Transcript provided by NPR, Copyright NPR.